A framework for ICT-based knowledge sharing in sustainable rural development : the case of Gilgit-Baltistan, Pakistan

Some 50% of the people in the world live in rural areas, often under harsh conditions and in poverty. The need for knowledge of how to improve living conditions is well documented. In response to this need, new knowledge of how to improve living conditions in rural areas and elsewhere is continuously being developed by researchers and practitioners around the world. People in rural areas, in particular, would certainly benefit from being able to share relevant knowledge with each other, as well as with stakeholders (e.g. researchers) and other organizations (e.g. NGOs). Central to knowledge management is the idea of knowledge sharing. This study is based on the assumption that knowledge management can support sustainable development in rural and remote regions. It aims to present a framework for knowledge management in sustainable rural development, and an inventory of existing frameworks for that. The study is interpretive, with interviews as the primary source for the inventory of stakeholders, knowledge categories and Information and Communications Technology (ICT) infrastructure. For the inventory of frameworks, a literature study was carried out. The result is a categorization of the stakeholders who act as producers and beneficiaries of explicit and indigenous development knowledge. Stakeholders are local government, local population, academia, NGOs, civil society and donor agencies. Furthermore, the study presents a categorization of the development knowledge produced by the stakeholders together with specifications for the existing ICT infrastructure. Rural development categories found are research, funding, agriculture, ICT, gender, institutional development, local infrastructure development, and marketing & enterprise. Finally, a compiled framework is presented, and it is based on ten existing frameworks for rural development that were found in the literature study, and the empirical findings of the Gilgit-Baltistan case. Our proposed framework is divided in four levels where level one consists of the identified stakeholders, level two consists of rural development categories, level three of the knowledge management system and level four of sustainable rural development based on the levels below. In the proposed framework we claim that the sustainability of rural development can be achieved through a knowledge society in which knowledge of the rural development process is shared among all relevant stakeholders.

Maternal health care professionals perspective on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam

Background. High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.